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MMWR Morb Mortal Wkly Rep. 2018 Jun 1;67(21):602-606. doi: 10.15585/mmwr.mm6721a3.
Progress Toward Rubella and Congenital Rubella Syndrome Control - South-East Asia Region 2000-2016.
Khanal S Bahl S Sharifuzzaman M Dhongde D Pattamadilok S Reef S Morales M Dabbagh A Kretsinger K Patel M.
Abstract
In 2013 the 66th session of the Regional Committee of the World Health Organization (WHO) South-East Asia Region (SEAR)* adopted the goal of elimination of measles and control† of rubella and congenital rubella syndrome (CRS) by 2020 (1). Rubella is the leading vaccine-preventable cause of birth defects. Although rubella typically causes a mild fever and rash in children and adults rubella virus infection during pregnancy especially during the first trimester can result in miscarriage fetal death or a constellation of congenital malformations known as CRS commonly including visual auditory and/or cardiac defects and developmental delay (2). Rubella and CRS control capitalizes on the momentum created by pursuing measles elimination because the efforts are programmatically linked. Rubella-containing vaccine (RCV) is administered as a combined measles and rubella vaccine and rubella cases are detected through case-based surveillance for measles or fever and rash illness (3). This report summarizes progress toward rubella and CRS control in SEAR during 2000-2016. Estimated coverage with a first RCV dose (RCV1) increased from 3% of the birth cohort in 2000 to 15% in 2016 because of RCV introduction in six countries. RCV1 coverage is expected to increase rapidly with the phased introduction of RCV in India and Indonesia beginning in 2017; these countries are home to 83% of the SEAR birth cohort. During 2000-2016 approximately 83 million persons were vaccinated through 13 supplemental immunization activities (SIAs) conducted in eight countries. During 2010-2016 reported rubella incidence decreased by 37% from 8.6 to 5.4 cases per 1 million populations and four countries (Bangladesh Maldives Sri Lanka and Thailand) reported a decrease in incidence of ≥95% since 2010. To achieve rubella and CRS control in SEAR sustained investment to increase routine RCV coverage periodic high-quality SIAs to close immunity gaps and strengthened rubella and CRS surveillance are needed.
PMID: 29851943 DOI: 10.15585/mmwr.mm6721a3